Just this week, the WHO released a report on global rates of infertility. Worldwide data shows that infertility affects about one in every six people.
And the rates appear to be more or less uniform in all regions of the world. The report highlighted discrepancies in fertility treatments; including diagnosis, access to treatment and affordability. The distress, stigma and financial hardships related to infertility should not be forgotten.
For the sake of clarity, infertility is defined as the failure to achieve a pregnancy after one year or more of unprotected sexual intercourse. It is a disease of either the male and/or female reproductive systems.
It should be reassuring to be aware that there are preventive strategies, and effective treatment options for people with infertility. But issues remain with funding for infertility treatment, and poor availability of services especially in low resource settings. On prevention, sexually transmitted infections (STIs) are the single most important cause of infertility in our part of the world. STIs damage reproductive organs in both men and women.
Fortunately, STIs and their reproductive sequalae are preventable. Simply using condoms prevents the spread of STIs, in addition to appropriate testing and prompt treatment when infected.
As age advances, reproductive capacity declines. Women in the late 30s onwards have declining egg numbers and quality, and will struggle to get pregnant. Sperm quality declines too with age. So beware when delaying conception to the later years. If unavoidable, you should always consider the option of freezing eggs or sperms for later use.
If you notice a delay in getting pregnant, seek appropriate help. All that is required is a reproductive evaluation, leading to a specific diagnosis and appropriate treatment. Women with telltale signs like irregular periods should seek help sooner. Equally, men with signs suggestive of poor reproductive capacity, like erectile problems, should be evaluated sooner.
If you end up requiring fertility treatment, you need to know where to go. The more you know about the quality of services you are seeking the better. You should enquire about the diagnostic process, treatment options and anticipated outcomes. Cost can be a limiting factor, so seek this upfront.
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Most people with a specific infertility diagnosis, being managed by a competent fertility team, will end up with successful treatment.
Others may still not become pregnant even with modern advances in fertility treatments. Other options such as adoption or choosing to remain childless become applicable in such situations.